What Can Be Done For The Scar On My Upper Lip?
Q: Hello Dr. Eppley, I wanted to that you for such a fast reply. I have looked through your facial scar revision work you have done and believe you can do something for me. I got a scar along my left lip to the side of my nose over one year ago. I have a few scars since I was a kid but I have gotten used to them. This new scar is by far the ugliest and biggest scar I have gotten. I don’t see anything but the scar when I look in the mirror and it bothers me alot. I understand that half of it is mental but I still would like to keep my face as close to perfect as possible. I already went and saw a doctor who charged me $150 for consultation and really couldn’t help me. I have used Bio Oil, and Mederma regularly and not sure if it’s a good thing to do. My scar is the same color as the rest of my skin but the only problem is its indented. All you see is a deep line which makes my appearance stand out. I went to a place where I paid lots of money and got some kind of liquid that they shot under the skin. It is a filler that only lasts 8 to 12 months. Like I said the scar being indented is the only problem. Whenever I stretch my mouth you can’t see the scar at all, and that’s all I need is to stretch my skin somehow so it stays that way. The filler they have shot in to my scar came in size .8, I have used .2 the first time and .2 the next time. I don’t know if any of this information helps but using that filler didn’t help much. Please tell me if using too much of Bio Oil or Mederma is bad for it. What are you suggestions?
A: Thank you for sending your history and the pictures. You have a mature scar that is obvious, not only by its location, but by its indentation along its entire vertical length. The indentation of the scar, fortunately, is in a favorable orientation being vertical on the side of the lip. That is advantageous for a favorable scar revision outcome.
As you have correctly pointed out, improvement in the scar is only going to come from improving its indentation. There are two options for long-term/permanent improvement. The first is to surgically treat it by doing a formal scar revision, excising the depression from the scar and re-closing it so that it is even. That will require a ‘stepping back’, so to speak, as the scar will be read for a while before the color fades. The other approach is to place a thin dermal graft underneath to push the indentation upward. That avoids cutting out the entire scar and the required time for scar fading. Either option is better, in my opinion, than injectable fillers and any method of skin resurfacing. You may stop the topical treatments as they will have no effect on a mature scar and are not capable of raising up the indentation.
Dr. Barry Eppley